HomeMy WebLinkAbout1752 D~cluatlo~ ot Oo~1ci1~ a~d Cit~~shlp
TO THE STATE ANO COUNTY TAX IISSESSOR. ,?,(1~~~
51. lUC1E COUNTY. FtORIDA:
This is my declarat+on of Oomicile and CitizK?thip i~ th~ St~te of Florida that I am filirp this day in aooordano~ ~nd
~n oonformity with Cfiapter 222, S~ttion 222.17, F{orida Statut~s.
1 was fo~me~ly a leflal resids~+t of ~~i~'~ D• C•
K~tY) (Sta»)
and I resided at _ 18~ Bilt~eat~ S~i~t. Ii• Qpppa _ liovveva~ 1 have chanqed my domic~le
(Street and Number) .
to and am and have bee~ a bona fide resident of th~ Stais of Florida sinoe ~e~ dey of
_ , 19 T~ , and I raside at ~ B°~ aTT~"T6
(Sheet and Number)
FORT ~RCE, SAiNT LUCIE COUNTY, RORIDA - .
and this stateme~t is to be taken as my dedaration of atizenship, actual leyal residenoe and daniule in the State of Florida.
(Insert hefe any pertinent facts, such as asle of propsrty or business, or relinqui~n+ent of employment
at former domicile, renwval of tamily to new domicik, purchase of honne, etc.)
~ ~w~st~ad
~I,ED AND R£~pltOFO -
sT lrCtf COiI11TY F't~, ~
ROCFR POIT~A=
CIER~ CIRC111T
~ECORO VERIFIEO
19 2 io PM'11
20~p~
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f 1 FURTHER GHtTIFY that 1 wil) oomply with all o4f~sr r~quiremMts of i Ipal r~iid~nt of thi: Stah. ~
I FURTHER CERTIFY thst 1 have na intention to return tq my former domicjle, and I intend to remain in FORT
PIERCE, SAINT LU~IE COUMY, FLORIDA, permanantly.
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(Nsms) H~'~ann lf~s~a
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- Sworn to snd wbscribsd before me this l.~h.- day of , 19~ZL.
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~ . CL~1( C ~ ~70tRT Notary Public
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~ dj~_ ~ ~ D.C. My Commis:ion ~xpire~
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~ ~3 ~ooKZ8~ ~~~174`~
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